End of life Flashcards
what is the medical model
- doctors are trained to diagnose and treat problems with the body
- receiving aggressive, ineffective treatments can reduce quality of life
- individuals don’t like spending time in the hospital as it feels like they are nearing end of life
what is palliative care
specialized healthcare for people with serious illness that focuses on improving quality of life
what is hospice
healthcare that focuses on improving quality of life, reducing pain, and prioritizing comfort in the end of life
outcomes of hospice residents
more likely to receive pain treatments
outcomes of palliative home care
lower depression levels, less symptom distress, and reported better physical health and quality of life
palliative care - being at home
- 3 quarters of Canadians say they want to die in their homes
15% die at home; 60% die in the hospital
BC palliative care benefits
allow patients to receive palliative care at home rather than be admitted to the hospital (access to the same medical supplies, equipment, and drugs)
a good death - free from pain
- having pain under control
- having control of bladder, bowels
- being able to breathe comfortably
a good death - surrounded by family and loved ones
- spend time with children/family as much as you want
- be touched and hugged by loved ones
- say goodbye to loved ones
- spend time with your spouse, partner
- spend time with pets
a good death - autonomy and control
- having control of the event
- discuss your wishes for end of life with doctor/others
- being able to feed oneself
- die with dignity and respect
what is prognosis awareness
the extent to which the patient is aware of their terminal illness (short-term life expectancy)
hope in terms of health
- hope is good (focus/belief in a future-orientated positive goal)
- reframing to goal of high quality of life rather than goal of a cure
acceptance in terms of health
- acceptance may affect some end-of-life care choices (less likely to have feeding tube in last week of life)
what is death anxiety
a sense of apprehension or fear at the thought of death or the process of dying
fear of death - intrapersonal
fear of impact on one’s body and psyche
fear of death - interpersonal
fear of impact on others and loss of social identity
fear of death - transpersonal
fears about the afterlife and uncertainty
religious and spirituality
- religious faith can bring hope and relieve death anxiety
- people with higher intrinsic religiosity express lower death anxiety
- religious rituals can provide comfort in times of stress
communicating death
- Junior doctors often have to notify the family about someone’s death
- stimulation-based training can help prepare doctors for real-world scenarios
what is brain death (brain stem death)
irreversible brain damage causing the end of independent breathing
organ donation
- organs are donated from those who are brain-dead/living donors
- basic understanding required for valid informed consent
(can donate kidney/lobe of your liver)
organ donation - opt-in vs opt-out
- Canada/USA use opt-in model
- Austria, France, Belgium, Wales, and Spain use opt-out model (presumed consent)
what is the default effect
making an option a default increases the likelihood that such an option is chosen
organ donation - mandatory approach
most organ donor organizations in Canada use a mandatory approach
- family members are asked to approve regardless of one’s organ donor registration status
